Provider Demographics
NPI:1508655788
Name:SELTZNER, EMILY J (RD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:SELTZNER
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N9121 COUNTY ROAD C
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:WI
Mailing Address - Zip Code:53956-9632
Mailing Address - Country:US
Mailing Address - Phone:608-617-7342
Mailing Address - Fax:
Practice Address - Street 1:N9121 COUNTY ROAD C
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:WI
Practice Address - Zip Code:53956-9632
Practice Address - Country:US
Practice Address - Phone:608-617-7342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered